Importance: The 2009 U.S. Health Information Technology for Economic and Clinical Health (HITECH) Act called for the creation of a meaningful use incentive program to provide financial support to providers and health systems that adopt electronic health record (EHR) technologies. Stage 2 of the meaningful use incentive program requires the active engagement of patients and their families with patient portal technology in managing their own health information and care coordination (Ford, et al., 2016).

Trends:

From 2008 to 2014, the percentage of patients who reported that it was very important for them to get their own medical information electronically increased from 58.3% to 69.1%.

From 2009 to 2014, the percentage of patients in metropolitan areas who reported that it was very important for them to get their own medical information electronically increased from 59.9% to 69.5%. Among residents of nonmetropolitan areas, the percentage increased from 50.3% to 66.9%.

Differences Between Groups:

In all years, patients age 65 and over were less likely than patients ages 35-64 to report that it was very important for them to get their own medical information electronically.

In all years except 2014, residents of nonmetropolitan areas were less likely than residents of metropolitan areas to report that it was very important for them to get their own medical information electronically.

Patients Who Found It Important To Get Their Own Medical Information Electronically

Patients who reported that it was very important for them to get their own medical information electronically, by race/ethnicity and education, 2008 and 2012-2014

Left Chart:

Race/Ethnicity

2008

2012

2013

2014

Total

58.3

70.3

64.9

69.1

White

58.8

71.1

66.4

70.3

Black

54.1

68.1

67.2

80.9

Asian

67.6

73.8

67.2

73

Hispanic

57.1

67.6

60.2

61.2

Right Chart:

Education

2008

2012

2013

2014

<High School

48.8

66.1

51.3

60.1

High School Grad

56.5

67.1

57.1

60.3

Some College

61.3

69.5

69.6

71.4

College Grad

60.8

75.1

69.5

74.5

Source: Health Information National Trends Survey. Iterations included in this chart are HINTS 3, HINTS 4 Cycle 1, and HINTS 4 Cycle 2. Available at http://hints.cancer.gov/.Note: White, Black, and Asian are non-Hispanic. Hispanic includes all races.

Importance: The 2009 U.S. Health Information Technology for Economic and Clinical Health (HITECH) Act called for the creation of a meaningful use incentive program to provide financial support to providers and health systems that adopt electronic health record technologies. Stage 2 of the meaningful use incentive program requires the active engagement of patients and their families with patient portal technology in managing their own health information and care coordination (Ford, et al., 2016).

Trends:

From 2008 to 2014, the percentage of patients who reported that it was very important for them to get their own medical information electronically increased:

From 58.8% to 70.3% for Whites.

From 54.1% to 80.9% for Blacks.

From 67.6% to 73.0% for Asians.

From 57.1% to 61.2% for Hispanics.

From 2008 to 2014, the percentage of patients who reported that it was very important for them to get their own medical information electronically increased:

From 60.8% to 74.5% for college graduates.

From 61.3% to 71.4% for patients with some college education.

From 56.5% to 60.3% for high school graduates.

From 48.8% to 60.1% for patients with less than a high school education.

Differences Between Groups:

In 2013, Black patients were more likely than White patients to report that it was very important for them to get their own medical information electronically.

In 2013 and 2014, Hispanic patients were less likely than White patients to report that it was very important for them to get their own medical information electronically.

Patients Who Found It Important for Doctors To Be Able To Share Their Medical Information With Other Providers Electronically

Patients who reported that it was very important that doctors and other health providers be able to share their medical information with other providers electronically, by age and residence location, 2008 and 2012-2014

From 2008 to 2014, the percentage of patients who reported that it was very important that health providers be able to share their medical information with other providers electronically increased from 46.7% to 63.0%.

From 2008 to 2014, the percentage of patients of metropolitan areas who reported that it was very important that health providers be able to share their medical information with other providers electronically increased from 47.3% to 64.3%. The percentage for residents of nonmetropolitan areas increased from 43.6% to 56.6%.

Differences Between Groups:

In all years, patients ages 18-34 were less likely than patients age 65 and over to report that it was very important that health providers be able to share their medical information with other providers electronically.

In 2013 and 2014, patients in metropolitan areas more likely than patients in nonmetropolitan areas to report that it was very important that health providers be able to share their medical information with other providers electronically.

Patients Who Found It Important for Doctors To Be Able To Share Their Medical Information With Other Providers Electronically

Patients who reported that it was very important that doctors and other health providers be able to share their medical information with other providers electronically, by race/ethnicity and education, 2008 and 2012-2014

Left Chart:

Race/Ethnicity

2008

2012

2013

2014

White

48.4

65.9

65.6

64.8

Black

41.8

63.7

59.7

62.1

Asian

43.8

66.1

64

64.9

Hispanic

45.1

55.6

59.9

58.3

Right Chart:

Education

2008

2012

2013

2014

<High School

43.7

65.7

57.7

63.4

High School Grad

43.7

63.4

63.7

53.7

Some College

46.8

61.2

63.3

62.7

College Grad

52.2

68.1

63.6

68.4

Source: Health Information National Trends Survey. Iterations included in this chart are HINTS 3, HINTS 4 Cycle 1, and HINTS 4 Cycle 2. Available at http://hints.cancer.gov/.Note: White, Black, and Asian are non-Hispanic. Hispanic includes all races.

From 2008 to 2014, the percentage of patients who reported that it was very important that health providers be able to share their medical information with other providers electronically increased:

From 48.4% to 64.8% for Whites.

From 41.8% to 62.1% for Blacks.

From 43.8% to 64.9% for Asians.

From 45.1% to 58.3% for Hispanics.

From 2008 to 2014, the percentage of patients who reported that it was very important that health providers be able to share their medical information with other providers electronically increased:

From 52.2% to 68.4% for college graduates.

From 46.8% to 62.7% for patients with some college.

From 43.7% to 53.7% for high school graduates.

From 43.7% to 63.4% for patients with less a high school education.

Differences Between Groups:

From 2012 to 2014, Hispanic patients were less likely than White patients to report that it was very important that health providers be able to share their medical information with other providers electronically.

Importance: Compared with paper, electronic provider documentation allows faster and more complete access to the patient record and may improve communication among members of the health care team. Some evidence exists that electronic documentation may be associated with improved patient outcomes and decreased costs (Hripcsak, et al., 2011).

Overall Rate: In 2013, 52.4% of hospitals had a computerized system for electronic clinical documentation, an increase from 29.6% in 2011 (data not shown).

Trends:

From 2011 to 2013, among hospitals with computerized systems that allow electronic clinical documentation, each component improved as follows:

Patient demographics, 87.1% to 93.0%.

Medication lists, 71.0% to 85.4%.

Nursing notes, 66.5% to 81.4%.

Advance directives, 64.3% to 79.7%.

Discharge summaries, 62.1% to 79.1%.

Problem lists, 58.0% to 76.2%.

Physician notes, 35.5% to 58.4%.

Hospitals With Computerized Systems That Allow Electronic Clinical Documentation With a Component for Discharge Summaries

Hospitals with computerized systems that allow electronic clinical documentation with a component for discharge summaries, by hospital control and hospital type, 2013

Importance: Compared with paper, electronic provider documentation allows faster and more complete access to the patient record and may improve communication among members of the health care team. Some evidence exists that electronic documentation may be associated with improved patient outcomes and decreased costs.

Differences:

In 2013, 66.6% of for-profit hospitals, 84.7% of not-for-profit hospitals, 95.5% of hospitals run by the Federal Government, and 72.5% of non-Federal hospitals and had a computerized system for electronic clinical documentation with a component for discharge summaries.

In 2013, 94.5% of children’s general, 83.0% of general medical and surgical, 66.2% of rehabilitation, 54.3% of acute long-term care, and 41.3% of psychiatric hospitals had a computerized system for electronic clinical documentation with a component for discharge summaries.

Importance: Use of EHRs directly affects the communication and management of laboratory information in patient care, particularly reporting results and test order management (Henricks, 2011).

Differences:

In 2013, 97.3% of children’s general, 84.1% of general medical and surgical, 50.0% of rehabilitation, 43.2% of acute long-term care, and 18.8% of psychiatric hospitals had a computerized system for results viewing with a component for diagnostic test results.

In 2013, among hospitals with computerized systems for results viewing, the percentage with a component for diagnostic test results was highest in hospitals with more than 400 beds (93.4%), followed by hospitals with 100-399 beds (86.8%), and hospitals with fewer than 100 beds (65.5%).

Importance: Clinical decision support (CDS) systems, which provide appropriate, timely, patient-specific reminders and information, are essential to cope with the growth in medical knowledge. When implemented effectively, CDS has been shown to improve quality and can be particularly effective for increasing appropriate use of evidence-based preventive services (Wright, et al., 2015).

Overall Rate: In 2013, 56.0% of hospitals had a computerized system for clinical decision support, an increase from 44.9% in 2012 (data not shown).

Trends:

From 2012 to 2013, among hospitals with computerized systems that allow clinical decision support, the percentage with the following components improved:

Drug allergy alerts, from 79.0% to 84.5%.

Drug-drug interaction alerts, from 78.3% to 83.9%.

Drug-lab interaction alerts, from 66.6% to 72.7%.

Drug dosing support, from 62.9% to 71.8%.

Clinical reminders, from 57.3% to 68.1%.

Clinical guidelines, from 53.8% to 67.0%.

Hospitals With Computerized Systems That Allow Decision Support With a Component for Clinical Guidelines

Hospitals with computerized systems that allow decision support with a component for clinical guidelines, by hospital control and hospital type, 2013

Importance: CDS systems, which provide appropriate, timely, patient-specific reminders and information, are essential to cope with the growth in medical knowledge. When implemented effectively, CDS has been shown to improve quality and can be particularly effective for increasing appropriate use of evidence-based preventive services (Wright, et al.).

Differences:

In 2013, 57.3% of for-profit hospitals, 75.4% of not-for-profit hospitals, 81.8% of hospitals run by the Federal Government, and 51.3% of non-Federal hospitals had a component for clinical guidelines.

In 2013, 89.4% of children’s general, 72.4% of general medical and surgical, 50.6% of rehabilitation, 30.7% of acute long-term care, and 19.9% of psychiatric hospitals had a component for clinical guidelines.

Hospitals With Computerized Systems That Allow Computerized Physician Order Entry

Hospitals with computerized systems that allow CPOE, by component, 2012-2013

Internet Citation: Use of Electronic Health Records. Content last reviewed June 2018. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/nhqrdr/chartbooks/carecoordination/measure5.html